Surrogacy Medications Explained
You’re matched with Intended Parents and gearing up for the transfer, which means you’ll soon be receiving a box of surrogacy medications.
This can be quite overwhelming at first, seeing the large box and its contents piled in front of you. But don’t you worry! We’re here to walk you through it all, medication by medication, and step by step.
Each doctor and fertility clinic will have their favored medication protocol. This is usually what the Reproductive Endocrinologist (RE) is comfortable with, and has good results from using. Still, the doctor will take your medical history into account, and then tailor the medication protocol to what your body needs. This is also why the monitoring appointments are so important, because the RE needs to monitor your levels to make sure everything is as close to perfect as possible for the transfer.
Because of this, not everyone will have the same surrogacy medications, or a set amount of time they will be on said medications.
The medications prescribed are meant to manipulate the surrogate’s body into believing she is pregnant, before she actually gets pregnant. Science is so fun!
More often than not you will be taking at least one medication as an injection. I know, I know. I’m not a fan of needles, either. Fear not – it’s all a head game! The anticipation is worse than the stick of the needle.
Receiving Your Surrogacy Medications
The initial shipment of your surrogacy medications will come together in one large box. As mentioned above, this can be overwhelming, yet absolutely exciting – things are getting real now!
The fertility clinic you’re working with will have sent over a list of medications with a start date for each of them, as well as instructions for dosages, and times to be taken. This can also be referred to as a “Calendar”. The wonderful nurses at your fertility clinic will take the time to walk you through your prescribed medications, and show you how to properly administer them. Should you need a little extra guidance, questions answered, or more, these nurses are only a phone call or email away, and will be there to help anytime you need them.
If you can’t get ahold of your nurses, chances are your SurroSisters (surrogates often to refer as one another as SurroSisters) will be able to help out, and offer encouragement. *Always follow your medication protocol exactly as it is written and explained to you by your fertility clinic. Remember, not everyone’s protocols will be the same.*
Let’s take a look at some of the medications you might be prescribed as a surrogate:
Birth Control Pills – Your clinic will use the birth control pills to manipulate your cycle. This is to get it on their schedule, often syncing with the Intended Mother or egg donor (for fresh transfers).
Lupron – Leuprolide Acetate Injection is commonly referred to as Lupron, and is given to stop the surrogate from ovulating during the cycle. Lupron is usually administered in the stomach area through a small 23 gauge needle. To learn more about Lupron follow this link: Lupron
Progesterone – is a natural hormone produced by the ovaries. It is given as a supplement to thicken the uterine lining and prepare the body to store the embryo. There are a few types of progesterone that can be prescribed by the RE:
- Progesterone in oil, which is an intramuscular injection, commonly referred to as PIO*
- Vaginal gel, such as Crinone or Prochieve
- Vaginal tablets such as Endometrin
- Oral tablets such as Prometrium, which is also prescribed to use vaginally
- Progesterone suppositories
- Progesterone lozenges, which are made to order by a pharmacist
*Progesterone in oil can also come in a variety of carrier oils. Some people experience a reaction when a particular carrier oil is used, and will need a different oil base prescribed. Currently we see carrier oils such as: olive oil, peanut oil, cottonseed oil, sesame oil, and ethyl oleate. Be sure to let the clinic know if you have any known allergies to any of these oils, before they are prescribed to you.
There are two needles for progesterone. The larger one is used to draw the medication from the vial, into the syringe, while the other (smaller needle) is the one you will inject with.
Estrogen – The way the estrogen is taken (mode of delivery) impacts how frequently it must be taken – whether multiple times a day, once a day, or less often. Progesterone and estrogen are both typically given leading up to transfer and throughout the first trimester. There are a few types of estrogen that can be prescribed by the RE:
- Transdermal patches placed on the belly
- Oral pills
- Vaginal tablets
Medrol – is a light steroid used to prevent any inflammation of the uterine lining that could prevent the embryo from successfully implanting.
Antibiotics – are used to ensure the uterus is free of any bacteria before the embryo transfer, and also to prevent any possible infection.
Again, these are just some of the medications you might be prescribed as a surrogate.
If you have any questions regarding any of the surrogacy medications prescribed to you, please ask your doctor or nurse. They are there to assist you in anything you may need, like making sure you are comfortable in knowing what you’re taking, what it does, and how to properly take or administer it.
If you have any reactions to the medications prescribed, inform your clinic immediately.
Check out two-time Gestational Surrogate, Elizabeth explain the medications she’s taking to gear up for her transfer:
Creating a Setup for Your Surrogacy Medications
Setting up a specific area to keep your surrogacy medications will help you get a good routine down. These medications will be part of your daily life for a good three months minimum, so you will want to have a system in place that works for you.
Will you be administering your own injections, or will someone be doing them for you? If someone is helping you with injections, is this person a constant in your life? e.g. a spouse, partner, family member.
You will need to take your medications at the same time each day. Be sure that you (and whoever is helping) are able to set up a specific time each day when you will take your medications and administer your injections.
Some of the setups we have seen:
Medicine cabinet. This was the setup I used during my surrogacy journey in 2009/2010. I cleared out an area in an above counter cabinet in my kitchen, taped the medication calendar to the inside of the cabinet, and kept everything within that area inside the cabinet. While this worked well for me, some may not have the room to spare in their kitchen or home.
Small desktop or tabletop organizer. We’ve all seen those little plastic 3 drawer organizers, and chances are you’ve purchased one at some point. They’re cheap and work well. You can easily use one to organize and store your surrogacy medications.
Over the door “shoe” organizer. I have seen a few people use this type of setup for their surrogacy medications, shared within some online surrogacy groups. They’re able to sort and organize the different medications and needles within each pouch, making this another cheap and easy organization method.
Tackle box. I have to admit I laughed upon hearing a SurroSister mention this particular setup. I kept picturing a huge tackle box – the kind that look almost like the Caboodles from the 80s/90s. But honestly, her setup is genius, and works so well! The slides for the compartments are adjustable and can be moved to fit your needs. It’s small, cheap, and makes travel easy.
Disposing of Your Surrogacy Medications
Your initial box of surrogacy medications will come with a sharps container for needle disposal. Instructions will also be sent with the medication on how to properly dispose of a needle after use. Still, I would like to mention it here as well.
After giving yourself an injection, place the plastic cap back over the needle and place in the sharps container. Keep this container out of reach of children. Once your sharps container is full, you will need to properly dispose of it.
NEVER throw your needles or sharps container into the trash!
The FDA suggests checking with local doctors offices, pharmacies, hospitals, and medical waste facilities for sharps container drop boxes or supervised collection sites. You can also ask the clinic you are working with for their recommended procedure for proper sharps container disposal.
That’s about all there is to it!
We hope this rundown of surrogacy medications helps you understand what you might come across in your surrogacy journey. If you have any questions on your medications, please make sure you ask your fertility clinic. If you have any other questions, feel free to message us.